Problemi correnti
È possibile prevenire l’abuso?
IS PREVENTION OF CHILD ABUSE POSSIBLE? A REVIEW OF INTERVENTION STUDIES
SILVIA PIVETTA1, ANNA MACALUSO1, PAOLA MATERASSI1, CHIARA CUOGHI2, GIORGIO TAMBURLINI3
1ASS n.1 Triestina, Unità Distrettuale per i Minori
2Servizio di Medicina Materno-Infantile ASL Ferrara
per la Cooperazione Internazionale (Centro collaboratore dell’OMS), IRCCS “Burlo Garofolo”, Trieste
Febbraio 1998 - pagg. 114 -118
Abstract
The Authors reviewed all available intervention
studies that included child abuse
among the endpoints. 9 published trials
were analyzed. Most of them were carried
out in US, a few in UK, Ireland and Canada.
The studies evaluated a wide variety of
antenatal and/or postnatal programmes
targeted to at risk mothers and included
one or more of the following interventions:
emotional and social support, information,
linkage to health, social and community
services. Home visits were made by professional
or non professional people. Many
trials showed a trend towards a protective
effect but results rarely reached statistical
significance due to insufficient sample size
or follow-up. The best results on prevention
of child abuse and neglect were shown by
the largest trial (324 mothers) with the longest
follow-up (15 years). It is practically
impossible to draw conclusions from studies
that were so etherogeneous. Preventive interventions
should have a much wider scope
that just prevention of child abuse,
should be non selective and multidimensional,
but this makes very difficult to evaluate
results on specific endpoints.
Classificazione MeSH
Bibliografia
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“Il pediatra e l’abuso all’infanzia”. Varenna,
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2. Johnson Z, Howell F, Molloy B: Community mother’s programme: a randomized controlled trial of non-professional intervention in parenting. BMJ 306, 1449-52, 1993.
3. Dawson P, Van Doorninck WJ, Robinson JL: Effects of home based, informal social support on child health. J Dev Behav Pediatr 10, 63-7, 1989.
4. Olds DL, Eckenrode J, Henderson CR Jr, et al: Long-term effects of home visitation on maternal life course and child abuse and neglect. Fifteen-year follow-up of a randomized trial. JAMA 278 (8), 637-43, 1997.
5. Lealman G, Haigh D, Philips J: Predicting and preventing child abuse - an empty hope? Lancet i, 1423-4, 1983.
6. Gray JD, Cutler CA, Dean JG, et al: Prediction and prevention of child abuse and neglect. J Soc Iss 35, 127-39, 1979.
7. Marcenko MO, Spence M: Home visitation services for at-risk pregnant and postpartum women: a randomized trial. Am J Orthopsychiatry 64, 468-78, 1994.
8. Barth RP: An experimental evaluation of in-home child abuse prevention services. Child Abuse Negl 15, 363-75, 1991.
9. Hardy JB, Street R: Family support and parenting education in the home: an effective extension of clinic-based preventive health care services for poor children. J Pediatr 115, 927-31, 1989.
10. Siegel E, Baumen KE, Schaefer ES, et al: Hospital and home support in infancy: impact on maternal attachment, child abuse and neglect, and health care utilization. Pediatrics 66, 183-90, 1980.
11. Ian Roberts, Michael S Kramer, Suissa S: Does home visiting prevent childhood injury? A systematic review of randomized controlled trials. BMJ 312, 29-33, 1996.
12. Olds DL, Charles R. Henderson, Tatelbaum R, et al: Improving the delivery of prenatal care and outcomes of pregnancy: a randomized trial of nurse home visitation. Pediatrics 77 ( 1), 16-28, 1986.
13. Olds DL, Henderson C.R., Chamberlin R, et al: Preventing child abuse and neglect: a randimozed trial of nurse home visitation. Pediatrics 78 (1), 65-78, 1986.
14. Olds DL, Kitzman H: Can home visitation improve the health of women and children at environmental risk? Pediatrics 86 (1), 108- 116, 1990.
15. Milani P: “Mamma con noi” un servizio di sostegno alla famiglia nel periodo post-natale. Rivista di Pediatria Preventiva e Sociale 46 (2), 59-77, 1996.
16. Cirillo G: Prevenzione e assistenza ai bambini napoletani a rischio sociale: l’adozione sociale. In: I bambini a rischio sociale: generazioni a perdere o investimento sociale, a cura di Cirillo G, Siani P, Tamburlini G. Edizioni Scientifiche Italiane, Napoli 1996.
17. Facchin P: Il trattamento di bambini e preadolescenti di famiglie a rischio sociale o multiproblematiche: ruolo del pediatra. In: I bambini a rischio sociale: generazioni a perdere o investimento sociale, a cura di Cirillo G, Siani P, Tamburlini G. Edizioni Scientifiche Italiane, Napoli 1996.
18. Arsieri R, Cataffo RN, D’Antonio AM, et al: L’identikit del neonato a rischio sociale. Quaderni ACP 5/6, 12-3, 1995.
19. La Gamba P: I segni del disagio alla nascita. In: I bambini a rischio sociale: generazioni a perdere o investimento sociale, a cura di Cirillo G, Siani P, Tamburlini G. Edizioni Scientifiche Italiane, Napoli 1996.
20. Perrault C, Coates AL, Collinge J, et al: Family support system in newborn medicine: does it work? Follow-up study of infants at risk. J Pediatr 108, 1025-30, 1986.
21. Larson CP: Efficacy of prenatal and postpartum home visits on child health and development. Pediartics 2 (66):191-7, 1980.
22. Kitzman H, Olds DL, Henderson CR Jr, et al: Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated child bearing. A randomized controlled trial. JAMA 278 (8), 644-52, 1997.
23. Sharon LH: Family-centered care. Ped Clin North Am 38 (6), 1545-61, 1991.
24. Gallio G: Lavoro territoriale e approccio di rete. Medico e Bambino 10, 67-71, 1997.
2. Johnson Z, Howell F, Molloy B: Community mother’s programme: a randomized controlled trial of non-professional intervention in parenting. BMJ 306, 1449-52, 1993.
3. Dawson P, Van Doorninck WJ, Robinson JL: Effects of home based, informal social support on child health. J Dev Behav Pediatr 10, 63-7, 1989.
4. Olds DL, Eckenrode J, Henderson CR Jr, et al: Long-term effects of home visitation on maternal life course and child abuse and neglect. Fifteen-year follow-up of a randomized trial. JAMA 278 (8), 637-43, 1997.
5. Lealman G, Haigh D, Philips J: Predicting and preventing child abuse - an empty hope? Lancet i, 1423-4, 1983.
6. Gray JD, Cutler CA, Dean JG, et al: Prediction and prevention of child abuse and neglect. J Soc Iss 35, 127-39, 1979.
7. Marcenko MO, Spence M: Home visitation services for at-risk pregnant and postpartum women: a randomized trial. Am J Orthopsychiatry 64, 468-78, 1994.
8. Barth RP: An experimental evaluation of in-home child abuse prevention services. Child Abuse Negl 15, 363-75, 1991.
9. Hardy JB, Street R: Family support and parenting education in the home: an effective extension of clinic-based preventive health care services for poor children. J Pediatr 115, 927-31, 1989.
10. Siegel E, Baumen KE, Schaefer ES, et al: Hospital and home support in infancy: impact on maternal attachment, child abuse and neglect, and health care utilization. Pediatrics 66, 183-90, 1980.
11. Ian Roberts, Michael S Kramer, Suissa S: Does home visiting prevent childhood injury? A systematic review of randomized controlled trials. BMJ 312, 29-33, 1996.
12. Olds DL, Charles R. Henderson, Tatelbaum R, et al: Improving the delivery of prenatal care and outcomes of pregnancy: a randomized trial of nurse home visitation. Pediatrics 77 ( 1), 16-28, 1986.
13. Olds DL, Henderson C.R., Chamberlin R, et al: Preventing child abuse and neglect: a randimozed trial of nurse home visitation. Pediatrics 78 (1), 65-78, 1986.
14. Olds DL, Kitzman H: Can home visitation improve the health of women and children at environmental risk? Pediatrics 86 (1), 108- 116, 1990.
15. Milani P: “Mamma con noi” un servizio di sostegno alla famiglia nel periodo post-natale. Rivista di Pediatria Preventiva e Sociale 46 (2), 59-77, 1996.
16. Cirillo G: Prevenzione e assistenza ai bambini napoletani a rischio sociale: l’adozione sociale. In: I bambini a rischio sociale: generazioni a perdere o investimento sociale, a cura di Cirillo G, Siani P, Tamburlini G. Edizioni Scientifiche Italiane, Napoli 1996.
17. Facchin P: Il trattamento di bambini e preadolescenti di famiglie a rischio sociale o multiproblematiche: ruolo del pediatra. In: I bambini a rischio sociale: generazioni a perdere o investimento sociale, a cura di Cirillo G, Siani P, Tamburlini G. Edizioni Scientifiche Italiane, Napoli 1996.
18. Arsieri R, Cataffo RN, D’Antonio AM, et al: L’identikit del neonato a rischio sociale. Quaderni ACP 5/6, 12-3, 1995.
19. La Gamba P: I segni del disagio alla nascita. In: I bambini a rischio sociale: generazioni a perdere o investimento sociale, a cura di Cirillo G, Siani P, Tamburlini G. Edizioni Scientifiche Italiane, Napoli 1996.
20. Perrault C, Coates AL, Collinge J, et al: Family support system in newborn medicine: does it work? Follow-up study of infants at risk. J Pediatr 108, 1025-30, 1986.
21. Larson CP: Efficacy of prenatal and postpartum home visits on child health and development. Pediartics 2 (66):191-7, 1980.
22. Kitzman H, Olds DL, Henderson CR Jr, et al: Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated child bearing. A randomized controlled trial. JAMA 278 (8), 644-52, 1997.
23. Sharon LH: Family-centered care. Ped Clin North Am 38 (6), 1545-61, 1991.
24. Gallio G: Lavoro territoriale e approccio di rete. Medico e Bambino 10, 67-71, 1997.